Hello

Renew wants to inform you of our Ethical Standards and Policies you that Renew has created to keep your information safe when communicating with you or with your healthcare providers.  This includes information we also may receive regarding the health care to you, or the payment of this health care. Renew must provide you with this Notice about its privacy practices, and such Notice must explain how, when, and why Renew will "use" and "disclose" your PHI.

 

A "use" of PHI occurs when Renew shares, examines, utilizes, applies, or analyzes such information within its practice; PHI is "disclosed" when it is released, transferred, has been given to, or is otherwise divulged to a third party outside of its practice. With some exceptions, Renew may not use or disclose any more of your PHI than is necessary to accomplish the purpose for which the use or disclosure is made. And, Renew is legally required to follow the privacy practices described in this Notice.
However, Renew reserves the right to change the terms of this Notice and its privacy policies at any time. Any changes will apply to PHI on file with Renew already. Before Renew makes any important changes to its policies, Renew will promptly change this Notice and post a new copy of it on its website as noted at the beginning of this document. You can also request a copy of this Notice from Renew, or you can view a copy of it on its website as noted at the beginning of this document.

III. HOW WE MAY USE AND DISCLOSE YOUR PHI?
Renew will use and disclose your PHI for many different reasons. For some of these uses or disclosures, Renew will need your prior authorization; for others, however, it does not. Listed below are the different categories of its uses and disclosures along with some examples of each category.
A. Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations Do Not Require Your Prior Written Consent Renew can use and disclose your PHI without your consent for the following reasons:
1. For treatment. Renew can disclose your PHI to physicians, psychiatrists, psychologists, and other licensed health care providers who provide you with health care services or are involved in your care. For example, if you're being treated by a psychiatrist, Renew can disclose your PHI to your psychiatrist in order to coordinate your care. However, it is its practice to only do so if you have directly authorized Renew in writing, unless a threat to your safety is involved.
2. To obtain payment for treatment. Renew can use and disclose your PHI to bill and collect payment for the treatment and services provided by Renew to you. For example, Renew might send your PHI to your insurance company or health plan to get paid for the health care services that Renew has provided to you. Renew may also provide your PHI to its business associates, such as billing companies, claims processing companies, and others that process its health care claims. All of Renew’s business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in Renew’s contract.
3. For health care operations. Renew can disclose your PHI to operate its practice. For example, Renew might use your PHI to evaluate the quality of health care services that you received or to evaluate the performance of the health care professionals who provided such services to you. Renew may also provide your PHI to Renew’s accountants, attorneys, consultants, and others to make sure Renew is complying with applicable laws
4. Other disclosures. Renew may also disclose your PHI to others without your consent in certain situations. For example, your consent isn't required if you need emergency treatment, as long as Renew tries to get your consent after treatment is rendered, or if Renew tries to get your consent but you are unable to communicate with Renew (for example, if you are unconscious or in severe pain) and Renew thinks that you would consent to such treatment if you were able to do so.
B. Certain Uses and Disclosures Do Not Require Your Consent. Renew can use and disclose your PHI without your consent or authorization for the following reasons:
1. When disclosure is required by federal, state or Iocal law; judicial or administrative proceedings; or, law enforcement. For example, RENEW may make a disclosure to applicable officials when a law requires Renew to report information to government agencies and law enforcement personnel about victims of abuse or neglect; or when ordered in a judicial or administrative proceeding.
2. For public health activities. For example, RENEW may have to report information about you to the county coroner.
3. For health oversight activities. For example, Renew may have to provide information to assist the government when it conducts an investigation
or inspection of a health care provider or organization.
4. For research purposes. In certain circumstances, Renew may provide PHI in order to conduct medical research, however we always obtain a release from the client when it comes to research.
5. To avoid harm. In order to avoid a serious threat to you or another person, Renew may disclose PHI to law enforcement personnel or persons able to prevent or lessen such harm.
6. For specific government functions. Renew may disclose PHI of military personnel and veterans in certain situations. And Renew may disclose PHI for national security purposes, such as protecting the President of the United States or conducting intelligence operations
7. For workers' compensation purposes. Renew may provide PHI in order to comply with workers' compensation laws.
8. Appointment reminders and health related benefits or services. Renew may use PHI to provide appointment reminders or give you information about treatment alternatives, or other health care services or benefits Renew offers.  You have the right to Opt-Out or Opt-In of these communication for appointments and/ updates to billing statements.  
C. Certain Uses and Disclosures Require You to Have the Opportunity to Object. Renew may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity to consent may be obtained retroactively in emergency situations.
D. Other Uses and Disclosures Require Your Prior Written Authorization. There are specific disclosures that would require your authorization, but that this practice does not do. These include disclosing your PHI for marketing purposes (marketing of services other than those of Families Counseling), sale of PHI to third parties, and fundraising purposes.   
In these, or any other situation not described in sections III A, B, and C above, Renew will ask for your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization (ROI)  to disclose your PHI, you can later revoke such authorization in writing to stop any future uses and disclosures (to the extent that Renew has not taken any action in reliance on such authorization) of your PHI by Renew.
E. We NEVER market or sell your personal information. We will NEVER disclose your information to third parties or explicitly use your information to market or solicit campaign materials to you. You have the right to OPT OUT of EMAILS and SMS text messaging regarding scheduling & billing. You can do this by logging into THERAPY PORTAL and selecting the box to OPT OUT of messaging. There is SECURE messaging located thru the TherapyNotes Portal as an alternative. You can also contact our offices at (502) 653-7211 to speak to a staff member for assistance for opting in or out of communication methods. 
IV. RIGHTS YOU HAVE REGARDING YOUR PHI You have the following rights with respect to your PHI:
A. The Right to Request Limits on Uses and Disclosures of Your PHI You have the right to ask that Renew limits how We use and disclose your PHI. Renew is not required to agree to your request unless you are asking Renew to restrict the use and disclosure of your Protected Health Information to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid Renew “out-of-pocket” in full. If Renew agrees, Renew will comply with your request unless the information is needed to provide you with emergency treatment. You may not limit the uses and disclosures that Renew is legally required or allowed to make.
B. The Right to Protect Services Paid for with Out-of-Pocket-Payments If you paid out-of-pocket (or in other words, you have requested that Renew not bill your health plan) in full for a specific item or service, you have the right to ask that your Protected Health Information with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and Renew will honor that request.
C. The Right to Choose How Renew Sends You PHI. You have the right to ask that Renew sends information to you to at an alternate address (for example, sending information to your work address rather than your home address) or by alternate means (for example, e-mail instead of regular mail) Renew must agree to your request so long as Renew can easily provide the PHI to you in the format you requested.
D. The Right to See and Get Copies of Your PHI In most cases, you have the right to look at or get copies of your PHI that Renew has, but you must make the request in writing. If Renew does not have your PHI but we know who does, Renew will tell you how to get it. Renew will respond to you within 30 days of receiving your written request. Renew may deny your request. If Renew does, Renew will tell you, in writing, its reasons for the denial and explain your right to have its denial reviewed. Instead of providing the PHI you requested, Renew may provide you with a summary or explanation of the PHI as long as you agree to that and to the cost in advance. If you request copies of your PHI, Renew will charge you not more than $1.00 for each page.
D. The Right to Get a List of the Disclosures Renew Has Made. You have the right to get a list of instances in which Renew has disclosed your PHI. The list will not include uses or disclosures that you have already consented to, such as those made for treatment, payment, or health care operations, directly to you, or to your family. The list also won't include uses and disclosures made for national security purposes, to corrections or law enforcement personnel, or disclosures made before April 15, 2003. Renew will respond to your request for an accounting of disclosures within 60 days of receiving your request. The list Renew will give you will include disclosures made in the last six years unless you request a shorter time. The list will include the date of the disclosure, to whom PHI was disclosed (including their address, if known), a description of the information disclosed, and the reason for the disclosure. Renew will provide the list to you at no charge, but if you make more than one request in the same year, Renew will charge you a reasonable cost based fee for each additional request.THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

This notice is effective the date you sign this form. It is good while you are in treatment; even if that treatment is intermittent.

In the case of no services for three years or more, the privacy form should be re-signed.